Aspiration Pneumonia and AD-Related Mortality Rates Decline Over Past 2 Decades

Although aspiration pneumonia (AP)- and Alzheimer disease (AD)-related mortality rates have decreased over the past 2 decades in patients with AD, the rates of decline are impacted by gender, race and ethnicity, and assisted living facility residence status. These are the results of a study presented at the 2025 American Academy of Neurology (AAN) annual meeting, held from April 5 to 9, 2025, in San Diego, California.

Patients with AD vs individuals without dementia are nearly twice as likely to have AP-related mortality.

To assess temporal trends in AP- and AD-related mortality, researchers from Dow International Medical College and Shaikh Zayed Hospital in Pakistan sourced data for this study from the Centers for Disease Control and Prevention (CDC) WONDER Multiple Cause of Death database. Individuals (N=115,288) aged 65 years or older who died from AP- or AD-related causes in the United States between 1999 and 2020 were evaluated for trends on the basis of sociodemographic and clinical characteristics.

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The age-adjusted mortality rates (AAMRs) for AP- and AD-related mortality were relatively stable from 1999 to 2002, at which point they declined with an average annual percentage change (AAPC) of -2.72% (95% CI, -3.24% to -2.08%) through 2020.

Stratified by sociodemographic characteristics, men had a higher mortality rate than women between 1999 (AAMR, 19.2 vs 13.4) and 2020 (AAMR, 9.9 vs 7.7), respectively. The mortality rate was higher among White individuals than Hispanic individuals (AAMR, 13 vs 10.7) whereas the mortality rate decreased over time among Black individuals (AAPC, -2.95 vs -2.07), respectively.

Stratified by region and state in the US, the highest mortality rates were observed in the West (AAMR, 15.3) and in Rhode Island (AAMR, 2.9). No significant trends were observed on the basis of rurality.

Nearly half of decedents (49.3%) lived in an assisted living facility at the time of their death.

“AP and AD-related mortality in elderly patients has significantly declined over the last two decades. However, significant disparities were noted among men, [non-Hispanic] White patients, and nursing home residents. This data highlights the need to identify healthcare barriers for vulnerable populations,” the researchers concluded.